Deparment of Nephrology, Ningbo Hwamei Hospital, University of Chinese Academy of Sciences, No.41, Xibei street, Zhejiang Province, 315010, Ningbo, China.
Life and Health Industry Research Institute, 315010, Ningbo, Zhejiang Province, China.
BMC Nephrol. 2021 Jun 3;22(1):209. doi: 10.1186/s12882-021-02414-x.
IgA nephropathy(IgAN)) is the common pathological type of glomerular diseases. The role of gut microbiota in mediating "gut-IgA nephropathy" has not received sufficient attention in the previous studies. The purpose of this study was to investigate the changes of fecal short-chain fatty acids(SCFAs), a metabolite of the intestinal microbiota, in patients with IgAN and its correlation with intestinal flora and clinical indicators, and to further investigate the role of the gut-renal axis in IgAN.
There were 29 patients with IgAN and 29 normal control subjects recruited from January 2018 to May 2018. The fresh feces were collected. The fecal SCFAs were measured by gas chromatography/mass spectrometry and gut microbiota was analysed by16S rDNA sequences, followed by estimation of α- and β-diversity. Correlation analysis was performed using the spearman's correlation test between SCFAs and gut microbiota.
The levels of acetic acid, propionic acid, butyric acid, isobutyric acid and caproic acid in the IgAN patients were significantly reduced compared with control group(P < 0.05). Butyric acid(r=-0.336, P = 0.010) and isobutyric acid(r=-0.298, P = 0.022) were negatively correlated with urea acid; butyric acid(r=-0.316, P = 0.016) was negatively correlated with urea nitrogen; caproic acid(r=-0.415,P = 0.025) showed negative correlation with 24-h urine protein level.Exemplified by the results of α-diversity and β-diversity, the intestinal flora of IgAN patients was significantly different from that of the control group. Acetic acid was positively associated with c_Clostridia(r = 0.357, P = 0.008), o_Clostridiales(r = 0.357, P = 0.008) and g_Eubacterium_coprostanoligenes_group(r = 0.283, P = 0.036). Butyric acid was positively associated with g_Alistipes (r = 0.278, P = 0.040). The relative abundance of those were significantly decreased in IgAN group compared to control group.
The levels of fecal SCFAs in the IgAN patients were reduced, and correlated with clinical parameters and gut microbiota, which may be involved in the pathogenesis of IgAN, and this finding may provide a new therapeutic approach.
IgA 肾病（IgAN）是常见的肾小球疾病的病理类型。肠道微生物群在介导“肠-iga 肾病”中的作用在以前的研究中尚未得到充分重视。本研究旨在探讨 IgAN 患者粪便短链脂肪酸（SCFAs）的变化，即肠道微生物群的代谢产物，及其与肠道菌群和临床指标的相关性，并进一步探讨肠道-肾脏轴在 IgAN 中的作用。
2018 年 1 月至 2018 年 5 月，共招募 29 例 IgAN 患者和 29 名正常对照者。采集新鲜粪便。采用气相色谱/质谱法测定粪便 SCFAs，采用 16S rDNA 序列分析肠道菌群，然后评估 α-和β-多样性。采用 Spearman 相关检验对 SCFAs 与肠道菌群进行相关性分析。
与对照组相比，IgAN 患者的乙酸、丙酸、丁酸、异丁酸和己酸水平明显降低（P<0.05）。丁酸（r=-0.336，P=0.010）和异丁酸（r=-0.298，P=0.022）与尿酸呈负相关；丁酸（r=-0.316，P=0.016）与尿素氮呈负相关；己酸（r=-0.415，P=0.025）与 24 小时尿蛋白水平呈负相关。以 α-多样性和 β-多样性的结果为例，IgAN 患者的肠道菌群与对照组有显著差异。乙酸与 c_Clostridia（r=0.357，P=0.008）、o_Clostridiales（r=0.357，P=0.008）和 g_Eubacterium_coprostanoligenes_group（r=0.283，P=0.036）呈正相关。丁酸与 g_Alistipes（r=0.278，P=0.040）呈正相关。与对照组相比，IgAN 组这些相对丰度明显降低。
IgAN 患者粪便 SCFAs 水平降低，并与临床参数和肠道菌群相关，可能参与 IgAN 的发病机制，这一发现可能为治疗 IgAN 提供新的途径。
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